Rubin G James, Amlôt Richard, Page Lisa, Wessely Simon
King's College London, Institute of Psychiatry, Department of Psychological Medicine, Weston Education Centre, London SE5 9RJ.
BMJ. 2009 Jul 2;339:b2651. doi: 10.1136/bmj.b2651.
To assess whether perceptions of the swine flu outbreak predicted changes in behaviour among members of the public in England, Scotland, and Wales.
Cross sectional telephone survey using random digit dialling.
Interviews by telephone between 8 and 12 May.
997 adults aged 18 or more who had heard of swine flu and spoke English.
Recommended change in behaviour (increases in handwashing and surface cleaning or plans made with a "flu friend") and avoidance behaviours (engaged in one or more of six behaviours such as avoiding large crowds or public transport).
37.8% of participants (n=377) reported performing any recommended behaviour change "over the past four days . . . because of swine flu." 4.9% (n=49) had carried out any avoidance behaviour. Controlling for personal details and anxiety, recommended changes were associated with perceptions that swine flu is severe, that the risk of catching it is high risk, that the outbreak will continue for a long time, that the authorities can be trusted, that good information has been provided, that people can control their risk of catching swine flu, and that specific behaviours are effective in reducing the risk. Being uncertain about the outbreak and believing that the outbreak had been exaggerated were associated with a lower likelihood of change. The strongest predictor of behaviour change was ethnicity, with participants from ethnic minority groups being more likely to make recommended changes (odds ratio 3.2, 95% confidence interval 2.0 to 5.3) and carry out avoidance behaviours (4.1, 2.0 to 8.4).
The results support efforts to inform the public about specific actions that can reduce the risks from swine flu and to communicate about the government's plans and resources. Tackling the perception that the outbreak has been "over-hyped" may be difficult but worthwhile. Additional research is required into differing reactions to the outbreak among ethnic groups.
评估对猪流感爆发的认知是否能预测英格兰、苏格兰和威尔士公众行为的变化。
采用随机数字拨号的横断面电话调查。
5月8日至12日通过电话进行访谈。
997名年龄在18岁及以上、听说过猪流感且会说英语的成年人。
建议的行为改变（增加洗手和清洁表面或与“流感伙伴”制定计划）和规避行为（采取六种行为中的一种或多种，如避免前往人群密集场所或乘坐公共交通工具）。
37.8%的参与者（n = 377）报告“在过去四天里……因为猪流感”采取了任何建议的行为改变。4.9%（n = 49）采取了任何规避行为。在控制个人信息和焦虑因素后，建议的行为改变与以下认知相关：猪流感严重、感染风险高、疫情将持续很长时间、政府可信赖、已提供良好信息、人们能够控制感染猪流感的风险以及特定行为能有效降低风险。对疫情不确定以及认为疫情被夸大与行为改变的可能性较低相关。行为改变的最强预测因素是种族，少数族裔参与者更有可能做出建议的行为改变（优势比3.2，95%置信区间2.0至5.3）并采取规避行为（4.1，2.0至8.4）。
研究结果支持向公众宣传可降低猪流感风险的具体行动以及传达政府计划和资源的努力。应对疫情被“过度炒作”的认知可能困难但值得。需要对不同种族群体对疫情的不同反应进行更多研究。
